As an aid to the early detection and treatment of disease, it has become well established that there are major public health benefits that result from regular endoscopic examination and subsequent or simultaneous treatment of internal structures, such as the alimentary canals and airways, e.g., the esophagus, stomach, lungs, colon, uterus, ureter, kidney and other organ systems. A conventional imaging endoscope used for such procedures is formed of a flexible tube that has a fiber optic light guide that directs illuminating light from an external light source to the distal tip, where it exits the endoscope and illuminates the tissue to be examined. Frequently, additional optical components are incorporated, in order to adjust the spread of light exiting the fiber bundle at the distal tip. An objective lens and fiber optic imaging light guide communicating with a camera at the proximal end of the endoscope or an imaging camera chip installed at the distal tip produces an image that is displayed to the examiner. In addition, most endoscopes include one or more working channels, through which medical devices, such as biopsy forceps, snares, fulguration probes, and other tools, may be passed.
Navigating the endoscope through complex and tortuous paths in a way that produces minimum pain, side effects, risk, or sedation to the patient is critical to the success of the examination. To this end, modern endoscopes include means for deflecting the distal tip of the endoscope to follow the pathway of the structure under examination, with minimum deflection or friction force upon the surrounding tissue. By manipulating a set of control knobs, the examiner is able to steer the endoscope during insertion and direct it to a region of interest, in spite of the limitations of such traditional control systems, which may be clumsy, non-intuitive, and friction-limited.
In some endoscopic procedures, it is desirable to pass an electrosurgical instrument through a working channel. The electrosurgical instruments are typically separate devices that are connected to a separate radio frequency (RF) generator source, i.e., electrosurgical generator, which is separate from the operator console of the endoscope. For example, a polypectomy snare is one such electrosurgical device that is used to perform a polypectomy procedure. A polypectomy procedure requires many steps that include, for example, the user's navigating the endoscope shaft through the colon, identifying the polyp to be removed, selecting a polypectomy snare of appropriate size, connecting the cable of the polypectomy snare to a separate electrosurgical generator, selecting the power level of the electrosurgical generator, positioning an activation foot pedal that is attached to the generator near the user, passing the polypectomy snare through the working channel, capturing the polyp in the snare, energizing the polypectomy snare with the foot pedal while viewing on a video display of the endoscope operator console, cutting off the polyp, de-energizing the polypectomy snare by removing pressure on the foot pedal, withdrawing the polypectomy snare from the working channel, and recovering the polyp through the working channel, either by suction or via another instrument.
The above-described process is very labor- and time-intensive, and the cost of the separate electrosurgical instrumentation, in combination with the endoscope system, is high and, thus, adds cost to the medical procedure. Many connections and settings have to be managed by the physician or assistant. For example, the physician cannot watch the video display of the endoscope operator console, while at the same time adjusting the settings of the electrosurgical generator, which is typically located behind the physician. Therefore, instructions are given to a nurse, for example, if the generator settings need adjustment. Overall, the system setup may be disadvantageous, in that there may be many electrical cords required in order to interconnect all the instrumentation that is typically set up in a small space, which may contribute to a less-than-safe working environment. Additionally, the foot pedal to energize the electrosurgical instrument is often awkward for the physician to locate and use. Furthermore, because the endoscope and the electrosurgical generator do not have a common user interface, the physician must familiarize himself/herself with the user interface of the endoscope as well as the user interface of all the different electrosurgical devices.
To overcome these and other problems, there is a need for a low-cost imaging endoscope and associated electrosurgical devices that can be used for a single procedure and thrown away. The endoscopic system should have improved simplicity and ease of use, a common user interface for the endoscope and associated electrosurgical devices, increased efficiency, greater clinical productivity and patient throughput, improved safety, and improved clinical advantages, by being able to do more than one task and, thus, fewer insertions, which has the result of requiring less medication and facilitating faster recovery for the patient. Additionally, it would be beneficial to provide an endoscopic system that has an improved data gathering and management system, i.e., fast and accurate electronic recording of all aspects of each procedure.